Map: Where people in the US are most vulnerable to delta change

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The patchwork nature of the coronavirus vaccination campaign in the United States has left people in many parts of the country still vulnerable to the virus and its rapidly spreading delta variant. An analysis by The New York Times showed that even areas absorbing large amounts of the vaccine or those hard hit in previous waves of the epidemic could see new outbreaks if vaccination rates do not increase.

Estimates developed by PHICOR, a public health research group, suggest that more than 40 percent of the US population may not be adequately protected against the delta variant.

Percentage of people exposed to the delta variant

Percentage of people exposed to the delta variant

Percentage of people exposed to the delta variant

Percentage of people at risk

Injury to the delta variable

Some of the least protected areas, such as counties in southern Missouri and northern Arkansas, are currently experiencing large outbreaks. In Taney County, Missouri, where only 28 percent of the population is fully vaccinated, the average number of cases reported per day is higher than ever, and hospitals in the area are seeing an increase in the number of COVID-19 patients.

In other areas of the country, vaccination rates are as high as 70 to 80 percent. But researchers say it’s possible that few, if any, counties have reached herd immunity — the point where enough people are immune that the virus is less likely to spread within a community. Since the delta variant is more contagious, this threshold is higher than before.

This means that a large part of the country is still vulnerable to the kind of rapid spread that could put pressure on hospitals and lead to worse outcomes for patients. Experts say the best protection for every community is to continue to vaccinate as many people as possible.

“Small increases in vaccination coverage can make a big difference in terms of reducing the number of cases,” said Bruce Y. Lee, a professor at City University of New York who is leading PHICOR’s research effort. “If you get a higher level in terms of immunity, the virus can slow down.”

The PHICOR estimates, which combine vaccination rates with estimates of immunity from previous infections, show that more than 98 percent of the US population lives in counties where less than 70 percent of the population is immunized. And 82 percent of people live in counties with less than 60 percent immunity.

To arrive at the risk level for each county, PHICOR researchers adjusted national estimates of Covid underreporting to approximate the true number of cases in each county. That means about 128 million cases nationwide — nearly four times the number of reported cases.

The researchers combined case estimates with vaccination rates in each county and adjusted the numbers to account for delta’s ability to evade natural defenses. The result is an estimate of the total number of people who are immune to the virus in each county, and an estimate of those who remain susceptible.

Even areas with high vaccination rates may still have pockets of weakness. And in all counties, children under the age of 12 are not eligible for the vaccination, making it easier for the disease to continue to spread as children return to school.

Take New York City, for example, where 54 percent of the city-wide population is vaccinated but there are large differences in vaccination rates between neighborhoods.

The proportion of the fully vaccinated population السكان

in Manhattan,

66% of people

They were fully vaccinated.

But some neighborhoods

It has vaccination rates

As low as 40%…

… while other regions

It has rates in the 1990s.

The proportion of the fully vaccinated population السكان

in Manhattan,

66% of people

They were fully vaccinated.

But some neighborhoods

It has vaccination rates

As low as 40%…

… while other regions

It has rates in the 1990s.

The proportion of the fully vaccinated population السكان

in Manhattan,

66% of people

They were fully vaccinated.

But some neighborhoods

It has vaccination rates

As low as 40%…

… while other regions

It has rates in the 1990s.

The proportion of the fully vaccinated population السكان

in Manhattan,

66% of people

They were fully vaccinated.

But some neighborhoods

It has vaccination rates

As low as 40%…

… while other regions

It has rates in the 1990s.

PHICOR is one of several research groups trying to model the course of the epidemic and where the virus may spread next. Jeffrey Shaman, an epidemiologist at Columbia University, leads a research group that has produced its own estimates and found fewer people at risk than PHICOR overall.

Dr. Shaman’s model showed broadly similar regional patterns, although measures of vulnerability differed by province due to the different methodology his team used. In general, he agreed that most of the country remains vulnerable to the delta variable, although he noted that some regions are at significantly greater risk of outbreaks than others.

“Areas with higher risk of infection will grow at a faster rate,” Dr. Shaman said. “You will see a bigger explosion of cases, they will peak at a greater number, and the total number of people infected will be greater.”

Projections compiled by the Centers for Disease Control and Prevention on average suggest that the number of new cases and deaths will continue to rise in the coming weeks now that delta is the dominant form of the virus in the United States. That could mean a return to preventive measures such as wearing masks for vaccinated people in some areas, given the uncertainty about supernatural infections.

“In communities where we’re starting to see significant rises in hospitalizations and cases, even vaccinated people need to do their part to slow transmission in the community as a whole,” said Lauren Ansel Meyers, an epidemiologist at the University of Texas at The University of Texas. Austin and Director of the UT Covid-19 Modeling Consortium.

There are some positive signs: The majority of adults over 65 in most counties have been vaccinated, providing strong protection against the worst outcomes for one of the most at-risk groups. And despite the recent spike in cases, the number of new Covid deaths has remained low.

But the pace of vaccination has slowed more than 80 percent since its peak in April, and more than half of people in the United States live in counties where most people are still not immunized.

Although super infections are rare, experts say that vaccinated people who live around large numbers of unvaccinated populations may be more susceptible to this infection because they are more likely to encounter the virus in the event of an outbreak.

“Every time you go out, there is a chance that you will come across someone who has not been vaccinated and may have had the virus,” Dr. Myers said. “The more people vaccinated, the less likely this is to happen.”

The varying levels of defense across the country pose an additional challenge to controlling the epidemic. “If the virus is still circulating locally in certain areas, it increases the likelihood of another variant emerging,” Dr. Lee said.

methodology

The district-wide immune protection model was developed by researchers in the Public Health Informatics, Computation and Operations Research (PHICOR) team at the City University of New York Graduate School of Public Health and Health Policy: Bruce Wayne Lee, Sarah Bartsch, and Kelly J. O’Shea, Patrick T. Wedlock and Mary C. Ferguson.

The model makes several assumptions about the nature of the virus, reported data, and vaccination. First, it assumes that natural immunity continues to offer the same level of protection over time to everyone who has recovered from the infection. What percentage of people who have recovered from infection become immune and how long immunity lasts remains open questions, but evidence suggests that immunity from previous infection alone is likely to last at least eight months.

The model also assumes that the probability of a person being vaccinated is the same as for people with normal and non-normal immunity. In other words, recovering from an infection does not make a person more or less likely to receive the vaccine.

The model uses national underreported numbers from the Centers for Disease Control and Prevention (CDC) to estimate total deaths and adjusts national underreported numbers of cases according to the average test positivity reported during the last quarter by county to account for differences between locations. This assumes that places with higher test positivity are missing more cases and therefore have a higher underreporting factor.

Finally, the model assumes that both innate immunity and imperfect immunity are present. It adjusts vaccine immunity according to the effectiveness of each brand of vaccine and applies these values ​​to each brand’s state use rates. The model assumes that natural immunity is 47 percent effective in preventing delta variant infection, based on results from laboratory studies.

Estimates for Georgia, Hawaii, Vermont, Virginia, West Virginia, and some counties in Alaska and California are not available due to insufficient vaccination data.

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